Bronchial Lipoma

Abstract

SESSION TITLE: Bronchology SESSION TYPE: Case Report Slide PRESENTED ON: Sunday, April 17, 2016 at 02:15 PM - 03:45 PM INTRODUCTION: Bronchial lipoma is a very rare benign tumor. By the bronchoscope interventional surgery one case was diagnosed in our hospital. CASE PRESENTATION: The patient was a 54-year-old man, ex-smoker for 30 years (90 pack-years). He had symptoms of cough, expectoration and fever for 3 months. Chest computed tomographic (CT) scan and 3D reconstruction of the trachea revealed a nodular lesion including a homogeneous fat density area, accompanied with obstructive change in the left upper lung field. The CT value of Mass is - 100 Hu. Rigid bronchoscopy revealed it to be a well-circumscribed, rounded, yellowish tumour that almost completely obstructed the entrance to the left upper lobe (figure 4). Bronchoscopic biopsy specimens showed fiber granulation and adipose tissue, with part of tumor surface coating bronchial epithelium and inflammatory cells. Pathological diagnosis was a lipoma (figure 5). Under general anesthesia residual tumor was resected via rigid bronchoscopy frozen, high-frequency electric coagulation trap electric cut, argon plasma coagulation (APC) intervention treatment; and surrounding mucosa was handled by congelation. DISCUSSION: The disease belongs to lung benign tumor, accounting for 0.1%-0.4%of all respiratory tract tumor[1], the current number of domestic reports is about 46, and plus this case, it is a total of 47 cases, 36 cases of men and women in 11 cases. Onset age from 19 to 74 years old, the average age (57±12) years old. Some scholars think that obesity and smoking is the susceptible risk factors of the disease. The high resolution CT can find the location and size of the early lesion in lungs, and can determine the nature of lump primarily according to CT value surveyed, lung lipoma belongs to low density organization, the edges of tumors are smooth, uniform density. The CT value of adipose tissue is between -40Hu-120Hu, so measuring the mass CT value can identify with other benign lung tumors. Most of scholars both Chinese and abroad promote excision under general anesthesia via rigid bronchoscopy, the microscopic interventional treatment method can be chosen, such as argon, carbon dioxide laser frozen, high-frequency electric coagulation trap electric cut, and lumen local radiotherapy, etc.[2] CONCLUSIONS: Curative effect of the APC under rigid bronchoscope to endobronchial lipoma is reliable; Bronchoscopic resection is the first choice to treat the disease. Reference #1: Muraoka M, Oka T, Akamine S, et al. Endobronchial lipoma: review of 64 cases reported in Japan [J]. Chest, 2003,123(1):293-296. Reference #2: A. H. Nassiri, H. Dutau, D. Breen et al., “A multicenter retrospective study investigating the role of interventional bronchoscopic techniques in the management of endobronchial lipomas,” Respiration, vol. 75, no. 1, pp. 79-84, 2008. DISCLOSURE: The following authors have nothing to disclose: Yuan Qing No Product/Research Disclosure Information